Length of hospital stay and stool frequency was not significantly different with either immediate feeding or graduated feeding in children with gastro-enteritis.

There is evidence of faster weight gain with immediate full strength feeding

Evaluation of infant feeding in acute gastro-enteritis.
Armistead J, Kelly D, Walker- Smith J
Journal of Paediatric Gastroenterology and Nutrition 1989; 8: 240-4.

Three-part Clinical Question
In children with gastro-enteritis is gradual introduction of feeding better than immediate normal feeding with regards to symptom control and time to resolution ?

Search Terms
Medline 1966-09/01 using ovid interface( exp gastro-enteritis) AND ( exp bottle feeding OR breast feeding OR exp feeding methods OR "feeding".mp) LIMIT to human AND (newborn infant OR infant OR preschool child OR child).

The Study
Non-blinded randomised controlled trial with intention-to-treat.

The Study Patients 68 infants, admitted or gastroenterology casualty clinic, less than 9 months old, acute diarrhoea and/ or vomiting for less than 7 days, bottle fed

Control group
(N = 22; 22 analysed): 24 hr dioralyte, quarter strength milk, diluted with dioralyte, increased by 1 quarter strength every 24 hrs

Experimental group
(N = 22; 22 analysed): 24 hr dioralyte then full strength milk

The Evidence

Non-Event Outcomes Time to outcome/s Control group Experimental group P-value
Hospital stay in days Days 1 to 4 4 (0.2) days 3.6 (0.6) days  NS
Weight gain (%)   +0.35 (0.5)

+0.65 (0.6)

Stool frequency  




? sufficient number, bottlefed only and sponsored by Nestle. Most mild dehydration.

Appraised by
Nico Grunenberg, Ravenswood Surgery, New Road, Forfar DD8 5AE; 20 November 2002
Email: peni.grunenberg@virgin.net